Neural Manipulation 1 Preparation

1. Review this video

2. Read: Trauma: An Osteopathic Approach

3. Review these slides

Important terms and structures important to

study prior to NM1 attendance.

Relationship of Spinal Nerves to Dura

Brachial Plexus ~ Lumbar Plexus ~ Sacral Plexus

Layers of the intracranial membrane system

Cranial Suture Anatomy – coronal, sagittal, lamdoid

Craniospinal Juncture Anatomy

Pelvic Ligaments – sacrotuberous, sacrospinous

Tentorium Cerebelli – anatomy of intracranial attachments

Brachial Plexus

Femoral Nerve

Sciatic Nerve

NM1 Preparation Quiz

Answers at the end

1. The coronal suture is between what 2 bones?

2. The occipito-mastoid suture/jugular foramen is between what 2 bones?

3. The falx cerebri is mostly under what suture?

4. The attachments of the tentorium cerebelli are:

a. frontal bone, petrouss part of temporal bone, occiput

b. occiput, parietal, temporal, bones, anterior and posterior clinoid processes of sphenoid bone

c. occiput, parietal and temporal bones, maxilla

Neural Manipulation

Neural Manipulation (NM)

is a gentle hands-on

therapy which helps to

free up the nerves and

the connective tissue

around the nerves (dura

mater), the bones around

the brain (cranium) so

that the nervous system

functions better.

(Barral & Croibier 2007)

“Neural” refers to the nervous

system of the body, which

includes the brain, spinal cord,

nerves of upper and lower

extremities, trunk and head.

Cranial Anatomy

Frontal bone

Parietal bones

Coronal suture

Sagittal suture

Sutures

The sutures provide for

growth and elasticity of

the newborn skull.

The begin to close after

3-4 months, however

the anterior fontanelle

will not close until 20

months (average).

They can be difficult to

palpate after 6 months.

(Pterion becomes squamosal suture)

(Asterion becomes occipito- mastoid suture)

Coronal suture

Lambdoidal

suture

Lateral View

Used with permission from Upledger Institute, Inc.

Coronal

suture

Lambdoidal

suture

Squamosal

suture

Occipital bone

Maxilla

Palantines

Sphenoid

Sphenobasilar junction/

Synchondroses

Temporal bone

Occipitomastoid suture

Bones: •Frontal •Parietal •Temporal •Occipital •Sphenoid •Maxilla

Sutures: •Coronal •Lambdoidal •Occipitomastoid

Used with permission from Upledger Institute, Inc.

Coronal

suture

Lambdoidal

suture

Squamosal

suture

Occipitomastoid suture = jugular foramen

(exit of jugular vein, vagus,

glossopharyngeal & accessory nerves)

Dural membranes: falx cerebri &

cerebelli, tentorium cerebelli

Tentorium: attaches to occiput, parietal,

petrous temporal, ant & post clinoid processes of

sphenoid

Vertex

Vertex

Layers of the Membrane System

Skin

Bone

Dura

Arachnoid

Pia

Brain

Expansion of the Nervous System

Jean Pierre Barral prefers to talk about expansion of the nervous system vs retraction rather than flexion/ extension of the craniosacral system.

Expansion includes not only the

cerebrospinal fluid, but the

expansion of the brain & meninges

via the arteries.

Expansion Retraction

Spinal cord & dural tube

Elongate. Feeling of

inflation in hand.

Spinal cord & dural tube

shorten. Feeling of

deflation in hand

Brain, dural membranes,

& cranium expand & widen

Brain, dural membranes

& cranium retract

towards center of head

NM1 Preparation Quiz

Answers

1. The coronal suture is between what 2 bones? Frontal/parietal

2. The occipito-mastoid suture/jugular foramen is between what 2 bones? Occiput/temporal

3. The falx cerebri is mostly under what suture? Sagittal suture

4. The attachments of the tentorium cerebelli are:

b. occiput, parietal, temporal, bones, anterior and posterior clinoid processes of sphenoid